Will the coronavirus outbreak affect my labour and who can be with me at the birth?

Will the coronavirus outbreak affect my labour and who can be with me at the birth?

What do the current lockdown rules mean for pregnant women who go into labour? Can you still have a birth partner? Can you have a home birth? And what will happen if you are self-isolating when labour starts? We get the latest expert advice

In a nutshell: The coronavirus outbreak means there will be changes to some of the ‘normal’ arrangements for labour and birth. Stretched midwife resources mean you may not be able to have a home birth, for example, and because of social distancing, there will almost certainly be restrictions on visitors on your hospital postnatal ward once you’ve given birth.

IMPORTANT NOTE: As the COVID-19 outbreak continues, things are constantly changing and not every hospital will have exactly the same policies in place at the same time. We will try to keep this page as updated as possible but, as you get closer to your due date, your midwife team will be the best source of information about what the exact current set-up is in your local area.

Can I still have a birth partner with me during labour?

Yes, you can have have a birth partner (no more than 1 person) – as long as your chosen birth partner isn’t displaying any symptoms of COVID-19 infection, and hasn’t had any symptoms in the past 7 days. As the new RCOG guidelines (3rd April 2020) say:

A single, asymptomatic birth partner should be permitted to stay... through labour and birth... Having a trusted birth partner present throughout labour is known to make a significant difference to the safety and wellbeing of women in childbirthRoyal College of Obstetricians and Gynaecologists

It’s important to check with your maternity unit whether your birth partner can arrive at hospital with you or not: some hospitals are asking you to come to the hospital on your own at first, so that they can confirm you are in labour and, only once they’ve confirmed that, will they call your birth partner to let them know they can now come in.

It’s likely that, when your birth partner arrives at the labour ward, they will be asked a series of questions to make sure they haven’t got any coronavirus symptoms and their temperature may be checked. Once inside, they will be asked to stay at your bedside and not walk about the ward or the hospital.

Obviously, if your birth partner is unwell or showing signs of coronavirus, they won’t be permitted to come into the labour ward with you. But they will be allowed to join you once you go into active labour and are moved to a delivery room.

What if I’m being induced? Can my birth partner stay with me?

It depends. If there’s space for you to be put in a single room while you’re induced (and provided your birth partner has no coronavirus symptoms), then your birth partner will probably be allowed to stay with you.

But, if your induction has to take place on a main ward, it’s probable that your birth partner will not be allowed to stay – because it would be impossible for social distancing measures to be maintained. However, as RCOG explains in a recent Q&A on their new coronavirus guidelines, your birth partner will be allowed to join you once you progress to active labour and are moved to a delivery room:

We understand that it must be very worrying if... your partner can’t be with you while you are being induced... This guidance is in place to protect other pregnant women and babies. Please be assured that, at the point you go into active labour, you will be moved to your own room and your birth partner will be able to join youRoyal College of Obstetricians and Gynaecologists

What if I’m having a C-section? Can my birth partner stay with me?

Probably, if it’s a planned Caesarean section. As long as your birth partner is asymptomatic, they should be allowed to be with you in the operating theatre while you’ve having a C-section. Because the operating team will be wearing PPE (personal protective equipment), they may not be able to speak to you or your birth partner easily, so it’s important that your birth partner listens carefully to the instructions given to them by the staff member allocated to support them.

Emma’s C-section ‘cororna’ birth story

Emma, one of our regular MadeForMums reviewers, gave birth to Lana Lily by elective section on April 15th. Here, she explains what happened during the birth – and afterwards:

“All the staff were dressed in full PPE for the procedure and we had to wait in the operating theatre for a certain amount of time after the birth before I was moved to recovery as part of their Covid-19 protocol.

“I had to wear a mask, as well as my husband during the section.

“My husband had to leave me as soon as I was moved to the ward and no visitors were allowed.

“Lana was taken for her baby checks without me as they had new rules in place. They brought her back to me afterwards.

“I was sent home the next day (which felt quite soon). I had to be escorted to meet my husband outside the main entrance by a member of staff who brought Lana in the hospital crib. I had to wheel/carry my bags, which was quite hard as Ifelt so tender and wobbly still.

“I was given blood-thinning injections for my other half to administer (all the women on my ward were given them) at home. I’ve had a C-section before but I have never had these before. I was briefly shown how it should be done and relayed this to my husband. God, it stings when he does it!

“It felt like a quite lonely experience, once I was moved to the ward.Having no visitors was so strange.”

If you have to have an emergency C-section (carried out under general, rather than local, anaesthetic), things may be different. Even before the coronavirus outbreak, it was not always possible for birth partners to be present during an emergency C-section. Now, with the operating theatres even more of a high-risk environment, “there will be some occasions,” says RCOG, “when it is not possible for your partner to be present”.

Can my birth partner stay with me after the birth?

This very much depends on the current policy in your hospital. Some hospitals are trying to discharge new mums and their babies within 6 hours of the birth (if that’s medically appropriate), which usually means birth partners can stay until then.

But, if you need to stay longer than that – or staffing shortages mean your discharge takes longer than 6 hours, you will be moved to the postnatal ward and, from what we’re hearing from new mums posting in our MadeForMums Chat forum, some hospitals are allowing birth partners to go postnatal ward, too, but others aren’t.

At NicolaCU‘s hospital, birth partners are currently allowed to stay after the birth. “I was allowed one birthing partner only and they were allowed to stay with me throughout as long as they didn’t leave,” she says. “My partner stayed with me and was also able to come down to the postnatal ward with me.”

But in KayleighA‘s area, things are different: “My friend had her baby in my hospital a few days ago,” she says. “Only one birth partner may accompany a woman in labour. After the birth, they have to leave and can’t come back.”

Can people visit me in hospital after the birth?

It’s possible that your birth partner may be allowed to visit but it’s very unlikely that wider family and friends will be able to. As our expert family GP Dr Philippa Kaye, explains:

Most hospitals are restricting visitors after the birth to one – your birthing partner – or none at all. This is to reduce footfall through the hospital to try and reduce infectionDr Philippa Kaye

Indeed, Christy on the MFM team, whose baby is due soon, says her midwife said that, where possible, her hospital discharges new mums as soon as possible after birth but, if they do have to stay in, they’re not allowed any visitors at all during that time.

Can I still have a home birth during the coronavirus outbreak?

Possibly but we suggest we really don’t count on it.

The official RCOG line is: “If you have chosen to give birth at home or in a midwife-led unit that is not co-located with an obstetric unit, it is worth noting that these services rely on the availability of ambulance services to allow for rapid transfer to hospital, and the right number of staff to keep you safe. If these are not in place, it is possible that your trust or board may not be able to provide these services.”

Roughly translated, this means that, while home births (and births in midwife-led units outside hospital premises) aren’t officially cancelled, it’s possible that your midwife team will decide that they can’t safely offer you a home birth during the coronavirus outbreak, either because they don’t have enough staff to spare 2 midwives to come to your home or because they aren’t confident there will be an available ambulance, should you or your baby need it – or both.

If you were planning a home birth, the best thing is to stay in touch with your maternity team (if they’re not updating you already), find out what the situation is where you are, and talk through how your birth would be managed if you need to come into hospital.

What happens if I go into labour while I’m self-isolating with coronavirus symptoms?

If you have suspected or confirmed coronavirus symptoms and you go into labour, you should call your maternity unit and let them you have symptoms. If your symptoms are mild, you’ll be encouraged to stay at home during the early stages of your labour – just as women without symptoms are encouraged to do, although you, of course, will still be in self-isolation.

When you and/or your maternity team believe your labour has progressed far enough for you to come to hospital, you should arrive by private transport if at all possible. You’ll be met at the maternity unit entrance and given a face mask which you’ll need to keep on until you can be put in an isolated room. Your birth partner will be allowed to stay with you and, if you haven’t already been tested for COVID 19, a test will be done.

Will my labour be managed differently if I have coronavirus symptoms?

Yes, although your midwives will still try to stick to your birth choices as closely as they safely can. The experts at RCOG say “there is no reason for to suggest you cannot give birth vaginally or that you would be safer having a caesarean birth if you have suspected or confirmed coronavirus”.

You will not be allowed to use the birthing pool and your baby will be continuously monitored. But you will be able to have pain relief, including an epidural and gas and air.

In our previous guidance it was suggested that the use of Entonox (gas and air) may increase spread of the virus but a review suggests there is no evidence for this, so there is no reason you cannot use gas and air in labourRoyal College of Obstetricians and Gynaecologists

However, if, during your labour, your breathing is affected by your illness in a way that suggests that your baby needs to be born urgently, it may be recommended that you have a Caesarean birth.

What if I’m booked for an induction and I have coronavirus symptoms?

If you are booked for an induction but have or develop coronavirus symptoms, your midwife team will assess you to see if your induction could be safely delayed. If that’s not possible and the induction needs to go ahead, you will be admitted into an isolation room and will probably stay there until you give birth.

What if I’m booked for an elective C-section and I have coronavirus symptoms?

If you are scheduled to have a C-section and have or develop coronavirus symptoms, your consultant will make a call on whether it’s safe to delay the procedure or not. The RCOG guidelines say: “An individual assessment should be made to determine whether it is safe to delay to minimise the risk of infectious transmission to other women, healthcare workers and, postnatally, to her infant.”

If it’s not safe to delay, the C-section will go ahead as planned, with extra precautionary measures taken to help prevent the spread of the virus to others in the operating theatre.

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.